2018 MIDTERM ELECTION

This seems awfully familiar.

Sec. Burwell responded in the only rational way possible: By pointing out that if [the Republican Party is] absolutely determined to destroy the lives of millions of likely voters across 34 states (including swing states like Florida, Ohio, Michigan and Wisconsin) while simultaneously forcing insurance premiums up an additional 35% - 45% for everyone else in those states (on top of whatever they were set to go up already), when it would literally take about 5 minutes for them to "fix" the very issue that they ginned up as the "problem" in the first place, there's not a hell of a lot that she can do to stop them.

...None of the above options involve anything that Sec. Burwell has any control over.

In other words, her only "contingency plan" is "try to convince the Republicans controlling the Supreme Court, Congress or those states to stop being colossal jackasses and actually do something to help the people they're supposed to be serving."

Not a plan likely to succeed, of course...but it's a plan.

...Yes, of course, it it does come to that, there's various negotiations that President Obama could discuss--the Medical Device tax, the SHOP exchanges, hell, even the Employer Mandate could theoretically be on the table....However, those would all still obviously require Republican action by definition.

And yes, as Sarah Ferris noted this morning at The Hill, the administration probably could provide a bit more guidance to the states about minimum requirements/procedures for "establishing" an exchange...However, again, that would still require the Republicans controlling those states to request the status change.